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News & Press: Public Heath News

March of Dimes releases 2019 Report Card

Wednesday, November 6, 2019  
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November is Prematurity Awareness Month and today we released the March of Dimes Report Card.

Attachments:  Wisconsin Report Card; 100 Cities (see Milwaukee has an F); US Report Card; Recommended Policy Actions; Prematurity Awareness Month Fact Sheet

Below and in attachments above is information about our just released 2019 March of Dimes Report Card.

The U.S. is facing an urgent maternal and infant health crisis. It’s one crisis, not two—as the health of moms and babies are intertwined. This crisis is about moms who die, those who nearly do and many who face serious health challenges before, during and after pregnancy. It’s about the health of babies born too soon and those we have lost. Ultimately, it’s about the continuum of care for all moms and babies.

  • For the fourth year in a row, more babies in the U.S. were born too soon and in one year alone, thousands do not survive due to a number of complications.
    • Premature birth increased from 9.63 percent in 2015 to 10.02 percent in 2018.
    • Each year in the U.S. approximately 1 in 10 babies is born preterm, which can lead to life-long health problems (e.g. cerebral palsy, intellectual disabilities, chronic lung disease, blindness and hearing loss).
    • In just one year, more than 22,000 infants die in the U.S. alone[1]—that is two babies every hour.
  • The rates of maternal death and severe pregnancy complications are unacceptably high. 
    • Approximately every 12 hours a woman dies due to complications resulting from pregnancy (approximately 700 women each year[2]). More than 60 percent of these deaths are preventable.[3]
    • The U.S. is among the most dangerous developed nations in which to give birth. (UN)
    • A significant racial disparity in maternal mortality exists with Black women being three to four times more likely to die from pregnancy compared to White women.[4] [5]
    • For every maternal death, over 50,000 suffer life-threatening health challenges. (CDC)

To elevate awareness of this maternal and infant health crisis, we are releasing the 2019 March of Dimes Report Card. For the first time, the Report Card shines a spotlight on the collective factors that contribute to maternal and infant mortality and morbidity, which moms and babies face together.

  • We know that medically, the health of moms and babies are interconnected.
    • For example, addressing maternal health factors, especially prior to pregnancy, increases the chances of a healthy full term birth. This includes identification and management of chronic conditions and intake of the vitamin folic acid to reduce birth defects.
    • We know that early delivery impacts both moms and babies. A preterm birth can lead to long-term health and developmental disabilities for babies. Sometimes women also face long-term health complications, for example, preeclampsia is linked to the development of heart disease and stroke in women after reproductive age. This is only compounded by the stress experienced by the entire family unit—which can have lasting impact. 
  • Beyond medical indications, we also know there are external factors that contribute to this crisis that we need to research further, such as access to health care, social determinants of health (e.g. poverty, access to health insurance) and implicit bias that exists.
  • We’ve designed the Report Card to take a more comprehensive view of the current state of maternal and infant health. That is why we added new features to this year’s Report Card:
    • More fine-grained distinctions with plus or minus grades, to capture smaller rate changes in prematurity.   
    • An added focus on maternal health as it relates to prematurity by highlighting solutions and policy actions that can make a difference.
    • Select social determinants of health to highlight the importance of inequalities that have negative consequences for moms and babies.
    • An estimated average cost of preterm birth by state.


It’s not fine. But with your help, it can be. The March of Dimes Report Card is a public call for action at the national, state and city levels to join us in the fight for the health of all moms and babies.


  • There are solutions that have improved preterm birth rates for specific populations and we can expand them to change the course of this maternal and infant health crisis. We recommend the following policy actions to create positive change:
  • Expanding programs that work, like group prenatal care.
  • Ensuring that women have access to public health insurance programs.
  • Expanding Medicaid to cover individuals with incomes up to 138 percent of the federal poverty level to improve maternal and infant health.
    • Making sure all women have Medicaid coverage for at least one year postpartum.
  • Establishing and funding Maternal Mortality Review Committees nationwide.
  • Increasing support for state-based Perinatal Quality Collaboratives, which have proven successful at improving maternal and infant outcomes by enlisting both providers and public health in improving the quality of care for mothers and babies. 
  • Addressing chronic inequities and unequal access to quality health care.
    • Reducing toxic stress, which contributes to maternal and infant health complications.
    •  Addressing implicit bias and structural racism in health care and community settings.


The Report Card grades the nation, all states, the District of Columbia and Puerto Rico based on the latest data on preterm birth rates.



  • The U.S. preterm birth rate rose to 10.02 percent of births in 2018, earning the nation a “C” grade.
  • After nearly a decade of declines, 2018 is the fourth year in a row with an increase. In 2015, the rate was 9.63 percent.
  • Each year in the U.S. approximately 380,000 babies—1 in 10—are born preterm, defined as less than 37 weeks of pregnancy.


Between 2017 and 2018, preterm birth rates worsened in 30 states. The Report Card shows that overall preterm births worsened in 30 states, with six states earning a failing grade.


Among the 100 largest U.S. cities, based on the number of births in 2017:

  • Cleveland, OH has the worst (highest) preterm birth rate at 14.5 percent.
  • The 10 cities with the highest rate of preterm births are:
    • Brownsville, TX
    • Milwaukee, WI
    • Birmingham, AL
    • Memphis, TN
    • Baton Rouge, LA
    • Baltimore, MD
    • New Orleans, LA
    • St. Louis, MO
    • Detroit, MI
    • Cleveland, OH
  • Cities with the lowest rate of preterm births are:
    • Ramapo, NY
    • Irvine, CA
    • San Francisco, CA
    • Irving, TX
    • Portland, OR

[1] Centers for Disease Control and Prevention, Infant Mortality

[2] Centers for Disease Control and Prevention, Pregnancy-Related Deaths

[3] Centers for Disease Control and Prevention, Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013–2017

[4] Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. Pregnancy-related mortality in the United States, 2006-2010. Obstet Gynecol 2015;125(1):5-12.

[5] Callaghan WM. Overview of maternal mortality in the United States. Semin Perinatol 2012;36(1):2-6. 

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